Hello, fellow washingtonian! I'm up in seattle! I don't know about the tax-free thing, I didn't pay "tax" to my plastic surgeon per se, he just gave me a quote and I paid that exact amount. I'm sure he figures his own taxes into the amount he charges me. But I was never assessed a separate tax. So you probably won't need to worry about that aspect of things.
I had a pricey plastic surgeon here in Kirkland, (the plastic surgery capital of Washington, so it seems). Paid $7,000 for breast lift, $7,000 for implants, and around $10,000 for fleur de lis (anchor cut/ vertical wedge- I have the vertical incision going up to the breastbone) abdominoplasty. Oh, and an additional $3,000 in hospital bills for complications that ensued from the tummy tuck. BTW abdominoplasty is the same thing as a tummy tuck, it's the official medical term. You may hear people talk about panniculectomies or pannus (panni) removals, those are NOT the same as tummy tucks, they are just the removal of the 'apron' of skin below the bellybutton, without tightening of the abdominal muscles. It's a less invasive procedure with more limited results.
So yeah, I spent about 27k on my boobs and belly. Most people will spend less. I found the best breast surgeon because my boobs were a MESS. You can look at my before/afters in my photos (friend me if you're not already). Mine looked like udders. Or windsocks. I wanted to stay local, and I'm very glad that I did because I suffered a lot of complications and needed to be seen for followup care by my surgeon. If I had to do it over again I would have insisted on spending the night in the hospital after my tummy tuck, even if I had to self-pay. That would've run me about $1,000 as opposed to the $3,000 I spent on an emergency blood transfusion a few days later. Not my surgeon's fault, I had an undiagnosed bleeding disorder.
What I'm trynna say is, be sure to budget for possible complications, for extra help if you need it, and for time off work. If you can just barely afford a procedure but will be financially ruined if you end up needing to spend a bit more on something unexpected, best to wait a little longer and save a little more. Many people here have had complications both minor and major. I was told I'd only need to take 3 weeks off work for my tummy tuck. I ended up recovering for 6 weeks (again, due to severe complications). **** happens.
As far as doing breasts and tummy together, I dunno. I couldn't have done it. When your abs are out of commision, you need your arms to help compensate. I would have been completely helpless because I was using my arms to push myself out of bed/chairs when I couldn't use my abs. If you've had your boobs done, you can't use your arms because they put the implant under the pec muscle (usually- not many people have it over the muscle), and every time you use your arms the pec contracts. If you overuse the arms while the breasts are healing, you risk bleeding, hematomas, scar tissue formation, capsular contracture, and lateral displacement of the implant (the muscle can pu**** out of place). My PS did my breasts first and my tummy tuck 1 month after that. They were both very major recoveries and I don't even want to imagine doing them together.
If, say, you were doing breasts and arms, that would be a good combo, because you can't use either together anyway. But you said your arms aren't too bad (lucky!) so that's a moot point. I know having two recoveries really sucks. But from my experience, I wouldn't combine those two particular procedures. I read a review over on realself.com from another person who had them done together and she regretted it because she was completely disabled.
I went on a LOT of consults in the seattle area and I can tell you that I really liked Dr Rand, Dr Baxter, and Dr Pratt (he's the one I went with). I have heard really good things about Dr Egrari but never consulted with him. I also met with Dr Anous, who was the least expensive, but was not impressed by some of the things his patients had to say about his aftercare. You gotta be careful about what you say in public forums so I'll leave it at that, you can message me if you want to discuss plastic surgeons in more detail.
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